Sarcopenia in Lung Cancer: A Narrative Review

Jogiat, Uzair; Jimoh, Zaharadeen; Turner, Simon R.; Baracos, Vickie E.; Eurich, Dean T.; Bédard, Éric

doi:10.1080/01635581.2023.2212425

Cited by 8 publications

(2 citation statements)

References 96 publications

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“…In this review article, we examined the possible interaction between PM and sarcopenia. It is already recorded that there is an interplay between sarcopenia and malignancies, and more specific, sarcopenia was significantly related to poorer prognosis across 12 types of cancer, among them lung, esophageal, gastric, hepatocellular, pancreatic, urothelial, head and neck, breast, colorectal, hematologic malignancies, and ovarian [66][67][68][69][70][71][72][73][74][75][76][77][78][79][80]. Additionally, in subjects diagnosed with cancer and cancer survivors, it has already been demonstrated that they have an accelerated decline in appendicular lean muscle mass and muscle mass loss in comparison with non-cancer subjects which might be related to impairment in physical function [66][67][68][81][82][83].…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia and Pleural Mesothelioma: The Current Knowledge

Karakousis,

Gourgoulianis,

Papanas

et al. 2024

Muscles

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Pleural mesothelioma (PM) is a tumor related to adverse prognosis. The PM WHO classification has mainly identified three major subtypes of PM which are epithelioid, biphasic, and sarcomatoid. Sarcopenia is a medical issue related to a reduction in muscle mass and strength. It represents a major health issue globally because it is related to adverse effects such as hospitalization, increased length of stay, disability, increased morbidity and mortality and augmented health care expenditures. In this literature review, we attempted to examine the upcoming association between sarcopenia and PM. As recorded by the current literature, muscle loss in PM subjects was related to poorer survival and lower levels of activity. Subjects with PM had increased rates of pre-sarcopenia and malnutrition, while pre-sarcopenia was related to worse activity levels, and malnutrition was related to worse quality of life (QoL). Both tumor volume and sarcopenia were related to long-term mortality in surgically treated PM subjects, while sarcopenia was present both pre-operatively and post-operatively in these subjects. In addition, post-operative sarcopenic subjects showed a decreased 3-year overall survival (OS) in comparison with those who did not have sarcopenia, while pre-operative sarcopenia was importantly related to an increased rate of post-operative adverse outcomes. More studies are needed to validate these claims.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia and Pleural Mesothelioma: The Current Knowledge

Karakousis,

Gourgoulianis,

Papanas

et al. 2024

Muscles

View full text Add to dashboard Cite

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“…Sarcopenia, characterized by a decrease of muscle mass and strength, is one of the signs of cancer ( 29 ). This is a recognized prognostic factor associated with poor prognosis of several cancers, including lung cancer ( 30 , 31 ), and survival ( 32 ). Furthermore, it shows a negative impact on most clinical outcomes of cancers.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological characteristics correlated with programmed cell death-ligand 1 expression in advanced lung adenocarcinoma

Gao,

Zou,

Wang

et al. 2023

J Thorac Dis

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Background Recent studies have shown that immune checkpoint inhibitors (ICIs) targeting programmed cell death-ligand 1 (PD-L1) have potential benefits in patients with non-small cell lung cancer (NSCLC) subgroups, while the clinicopathological characteristics associated with PD-L1 expression have not been well established. The purpose of this study was to detect the expression level of PD-L1 in tumor tissues of patients with advanced lung adenocarcinoma (ADC) and analyze its possible relationship with clinicopathological characteristics, so as to identify the predictors of PD-L1 expression. Methods This retrospective study was conducted by analyzing the clinicopathological and imaging characteristics of hospitalized advanced lung ADC patients with PD-L1 available data and admitted to the respiratory department of our hospital. The expression level of PD-L1 in fresh-frozen tumor tissue samples of 136 advanced ADC patients was analyzed by immunohistochemistry. The patients were divided into positive and negative groups based on a cut-off of 1% PD-L1 expression level. Subsequently, the significant correlation between PD-L1 levels and clinicopathological features were evaluated. The predictive performance of clinicopathological characteristics on PD-L1 expression was evaluated and the optimal cut-off values were identified by plotting the receiver operating characteristic (ROC) curve. Results The expression level of PD-L1 was related to sex, clinical stage, serum carcinoembryonic antigen (CEA), neuron specific enolase (NSE), white blood cell (WBC), and tumor (T) and metastasis (M) stage. Multivariate logistic regression analysis showed the CEA, NSE, T stage, and WBC were independent predictors of PD-L1 positive expression in lung ADC patients. The ROC curve suggested the model combining CEA with NSE [area under the curve (AUC) =0.815] could better predict the expression levels of PD-L1. The optimal cut-off values for identifying advanced lung ADC patients with PD-L1 positive were CEA ≤13.38 ng/mL and NSE ≤42.35 ng/mL, with sensitivity and specificity of 85.4% and 55.6%, and 92.7% and 32.1%, respectively. Conclusions Some commonly used clinicopathological features are related to the histological expression of PD-L1. The serum CEA, NSE, T stage, and WBC values can be used as indicators to predict the expression level of PD-L1 in advanced lung ADC, and are used as predictors to evaluate the efficacy of ICIs before treatment.

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Body composition derangements in lung cancer patients treated with first‐line pembrolizumab: A multicentre observational study

Trestini,

Belluomini,

Dodi

et al. 2024

J cachexia sarcopenia muscle

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BackgroundWhile immune checkpoint inhibitors (ICIs) are increasingly reshaping the therapeutic landscape of non‐small‐cell lung cancer (NSCLC), only a limited proportion of patients achieve a relevant and long‐lasting benefit with these treatments, calling for the identification of clinical and, ideally modifiable, predictors of efficacy. Body composition phenotypes may reflect aspects of patients' immunology and thereby their ability to respond to ICIs. This study aims to explore the possible association between pre‐treatment body composition phenotypes, tumour response, and clinical outcomes in patients receiving first‐line pembrolizumab monotherapy for advanced NSCLC.MethodsA retrospective review of consecutive patients with treatment‐naïve NSCLC and PD‐L1 expression ≥50% undergoing pembrolizumab at three academic institutions was performed. Pre‐treatment body composition parameters were measured at the third lumbar vertebra level by computed tomography, defined using pre‐established cut‐offs. Primary endpoint was objective response rate (ORR), secondary endpoints progression‐free survival and overall survival (PFS and OS), compared through the log‐rank test and the Cox proportional hazards model.ResultsData from 134 patients (93 males [69.4%] and 41 females [30.6%]) were collected. Median age was 69 years (range 36–85), with a median follow‐up of 12 months (range 1–131). The median body mass index (BMI) was 24.5 (IQR 21.5; 26.1) kg/m2. Overall, 59.0% and 51.5% of patients met established radiographic criteria for evidence of sarcopenia and myosteatosis, respectively, which occur across the BMI spectrum. Multivariate regression analysis, adjusted for co‐morbidities, revealed that sarcopenia (aOR 5.56, 95% CI. 2.46–12.6, P < 0.0001) and low intermuscular adipose tissue (IMAT) area (aOR 1.83, 95% CI. 1.22–2.83, P = 0.001) were associated with a lower rate of ORR (30.4% vs. 70.5%, P < 0.0001 and 30.7% vs. 73.2%, P < 0.0001, respectively). Moreover, both in univariate and multivariate analysis, adjusted for co‐morbidities, low performance status according to the Eastern Cooperative Oncology Group scale (ECOG PS), sarcopenia and low IMAT were significantly related to short PFS (ECOG PS: aHR 2.73, 95% CI 1.60–4.66, P < 0.0001; sarcopenia: aHR 2.24, 95% CI 1.37–3.67, P = 0.001; IMAT depot: aHR 2.26, 95% 1.40–3.63, P = 0.002) and OS (ECOG PS: aHR 3.44, 95% CI 1.96–6.01, P < 0.0001; sarcopenia: aHR 4.68, 95% CI 2.44–8.99, P < 0.0001; IMAT depot: aHR 3.18, 95% 1.72–5.88, P < 0.0001).ConclusionsSkeletal muscle abnormalities, apparently frequent in NSCLC, potentially represent intriguing predictive markers of response to ICIs and survival outcomes. Large prospective trials are needed to validate ICIs responders' clinical biomarkers.

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Sarcopenia in Lung Cancer: A Narrative Review

Cited by 8 publications

References 96 publications

Sarcopenia and Pleural Mesothelioma: The Current Knowledge

Sarcopenia and Pleural Mesothelioma: The Current Knowledge

Clinicopathological characteristics correlated with programmed cell death-ligand 1 expression in advanced lung adenocarcinoma

Body composition derangements in lung cancer patients treated with first‐line pembrolizumab: A multicentre observational study

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